title: Geriatric assessment is associated with completion of  chemotherapy, toxicity, and survival in older adults  with cancer.
abstract: OBJECTIVE
  Our purpose was to determine whether geriatric assessments are associated with completion of a chemotherapy course, grade III/IV toxicity or survival in older adults with cancer.
  
  
  METHODS
  In this prospective cohort study, patients aged 65 years and older with colorectal, lung, or breast cancer or lymphoma completed a brief geriatric assessment prior to chemotherapy. Endpoints included completion of the planned number of chemotherapy cycles, grade III/IV toxicity and survival. Multivariate logistic regression determined which factors were independently associated with completion of therapy, grade III/IV toxicity or death.
  
  
  RESULTS
  Sixty-five patients were enrolled in the study. The median age was 73 years (range 65–89). Geriatric syndromes were common, including depression (21.5%), dependence on others to carry out instrumental activities of daily living (38.5%) and activities of daily living (10.8%), and comorbidities (mild 47.7%, moderate 20%, severe 15.4%). Of the 65 participants, 67.6%completed the planned number of chemotherapy cycles. Curative intent therapy [OR 4.97 (95% CI 1.21–18.81)], Eastern Cooperative Oncology Group (ECOG) performance status 2–3 [OR 0.089 (0.015–0.53)] and renal function [OR 1.03 (1.00–1.06) per ml/min] were significantly associated with therapy completion. Furthermore, 31.1% experienced grade III/IV nonhematologic toxicity. Moderate to severe comorbidities significantly increased the risk of grade III/IV non-hematologic toxicity [OR 6.13 (1.65–22.74)]. Patients who received chemotherapy with curative intent had lower mortality [HR 0.15 (0.06–0.42)], while patients who reported a fall in themonth prior to chemotherapy had an increased risk of death [HR 3.20 (1.13–9.11)].
  
  
  CONCLUSIONS
  Geriatric assessment is associatedwith completion of a planned number of cycles of chemotherapy, grade III/IV non-hematologic toxicity, and mortality.
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Wildes
authors.forename: Alexander P
authors.initials: AP
authors.lastname: Ruwe
authors.forename: Chloe
authors.initials: C
authors.lastname: Fournier
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Carson
authors.forename: Jay F
authors.initials: JF
authors.lastname: Piccirillo
authors.forename: Benjamin
authors.initials: B
authors.lastname: Tan
authors.forename: Graham A
authors.initials: GA
authors.lastname: Colditz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000401:mortality; D005260:Female; D015577:Geriatric Assessment; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality; D008223:Lymphoma / Q000188:drug therapy / Q000401:mortality; D008297:Male; D055118:Medication Adherence; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality; D057240:Patient Preference; D011446:Prospective Studies